These multistate plans were included in President Obama’s health care law as a substitute for a pure government-run health insurance program — the public option sought by many liberal Democrats and reviled by Republicans. Supporters of the national plans say they will increase competition in state health insurance markets, many of which are dominated by a handful of companies.

The federal health plans are run by private insurance companies, but the government can negotiate the benefits and premiums. So this move by the Obama administration is a far cry from a public option. But that didn’t stop one conservative from sounding the alarm.

Robert E. Moffit, a senior fellow at the conservative Heritage Foundation, said he worried that “the nationwide health plans, operating under terms and conditions set by the federal government, will become the robust public option that liberals always wanted.”

Although many on the left supported the public option, many single payer advocates vehemently opposed it, preferring instead an automatic expansion of Medicare to all Americans. So it’s telling that something far less than single payer would make Mr. Moffit a bit nervous. Why would he (and perhaps other free-market advocates) be so concerned that these privatehealth benefits, under contract with the federal government, could suddenly morph into an entirely public plan? Maybe the idea of a public health plan has broader appeal than free marketers want to admit. The Government Employees Health Association, the organization that oversees federal employee health benefits, consistently gets high marks for patient satisfaction. And Medicare – a true single payer program – is immensely popular.

If large numbers of Americans end up choosing the federal plans in the health exchanges over other types of plans, that might take the steam out of a lot of anti-government rhetoric. If the majority of Americans find that they like their health benefits regulated by the government, it just might be easier for them to make the mental leap to accepting a system where health care isprovided by the government. And that’s a very scary prospect for proponents of profit-driven health care.

In what strikes me as the greatest combination since chocolate met peanut butter, it makes nothing but dollars and sense for clever state governments to shift to a single-payer state healthcare system as the key driver for attracting business to their struggling domains.

Ungar goes on to explain how single payer would benefit businesses, especially small businesses, by reducing labor costs and making them more competitive with foreign companies. He implores conservative state legislators to drop their ideological (and I would add, irrational) fear of creeping Communism, and be open to an idea that would spark economic prosperity. These legislators should listen.

But in America, ideology often trumps common sense – especially when that ideology provides some people a lot of money and power. Since the business community is so powerful here in America, it’s frustrating that more small businesses and corporations don’t join the Medicare-for-all movement. Businesses would rather not shell out the increasingly high cost of health care benefits for their employees. But you don’t see many businesses begging the government to take over the responsibility. You don’t see many of them using their powerful lobbyists to persuade conservative lawmakers to vote in favor of a public healthcare system. Instead, many businesses prefer to shove more and more of the costs onto their employees. Or they drop coverage altogether and create more uninsured people, which ends up shoving the costs onto taxpayers.

In America, anything that smacks of the dreaded “S-word” is to be automatically dismissed. In America, government is bad; privatization and profit are good. People are all forced to play the free-market game, even when it doesn’t make sense. If businesses can’t or won’t provide health coverage, then Americans should purchase private insurance in the open market (the more deregulated, the better), or they can just go without. A public healthcare system that will actually cover everyone and save money continues to be a non-starter. I hope more positive articles about single payer in the business press can change these outdated attitudes.

Here’s how things shape up when you compare healthcare costs and life expectancy in the OECD to the United States.

This Societe Generale chart from a recent article in The Economist tells you everything you need to know. The Japanese spend a fraction of what we do, cover all their citizens, and have a far better life expectancy than Americans.

Note, as usual, the U.S, and our free-market, profit driven healthcare system is the pathetic outlier. We spend way, way more and get miserable results. Our life expectancy is by no means the envy of the world.

When the next large scale disaster strikes in the United States, we’ll be in a bind. If it’s on the scale of what just happened in Japan, this country and its citizens would be in a world of hurt. Since we have abdicated our collective societal healthcare needs to the insatiable profit greed of Wall Street, we have 60 million with no access to healthcare.

What would happen to all these Americans at the mercy of our capricious, dysfunctional and depraved American healthcare system in a large disaster is unfathomable?

Tens, hundreds of thousands would likely be severely injured requiring extensive and expensive healthcare. Many, perhaps most of these people would either not be insured or dangerously underinsured. This reality would add a particularly gruesome uniquely American overlay for the world to ponder in horror.

Wondering how this country would address the healthcare needs of a huge uninsured and underinsured population in the aftermath of a national catastrophe is a long overdue discussion. And don’t count on the traditional media to begin it. Would we have millions of gravely injured Americans facing healthcare-related financial ruin and bankruptcy? Or would the barbaric reality of our profit-driven healthcare system crumble before the scrutiny of the world.

I suspect (or maybe I’m engaged in magical thinking) the latter. The government would have to intervene in a massive show of force. Nationalize the insurance companies? Require the for-profit parasites to cover everyone? Regulate rates so ordinary Americans could afford to get coverage? Institute community rating and guaranteed issue across the board? Massive open enrollment to Medicare and Medicaid?

Everything would have to be on the table, and perhaps we’d be on our way to single payer.

Right now, you can help us move California to single payer. When the for-profits in California fall (as they will), it will only be a matter of time for the domino effect to ripple across much of the nation.

Does everyone know that in Canada, single payer began at the provincial level in Saskatchew­an and then eventually , as more provinces embraced universal health care, the federal government got on board. This is how it will happen in the United States, but it will take all of us.